Spacecraft Dynamics and Control (2)Space exploration and regulation (2)History and Developments in Astronomy (2)Food Allergy and Anaphylaxis Research (1)Autoimmune Neurological Disorders and Treatments (1)
Vundamati VS, Patel SR, Patel R, Eriskin N, Tila-Cohen B, et al.
Cureus •
Alpha-gal syndrome (AGS) is characterized by an IgE-mediated immune response against galactose-α-1,3-galactose (α-gal). In the United States, the principal vector is the lone star tick, whose range has expanded nationwide. A lone star tick bite delivers α-gal into human skin via its saliva, triggering an IgE response in susceptible individuals. Vomiting, urticaria, and anaphylaxis may occur immediately or hours after exposure. However, perioperative ingredients, such as gelatin, monoclonal antibodies, stearic acid, and other mammalian-derived products, have triggered anaphylactic shock in patients with AGS. These nuances complicate AGS management as many cases go unrecognized. This review aims to look beyond traditional food-related reactions, characterize the range of presentations, and improve management of this increasingly recognized condition. The inclusion criteria required original research in English peer-reviewed journals between January 1, 2000, and March 22, 2026. Eligible studies included quantitative, qualitative, and mixed-method designs examining AGS acquisition. Relevant tick studies were included. Systematic reviews, scoping reviews, meta-analyses, case reports, series, and studies involving pregnant individuals or children, lacking full-text, duplicate publications, or overlapping datasets were excluded. Authors screened publications using Rayyan (Rayyan Systems Inc., Cambridge, USA). Discrepancies were resolved through discussion. Of the 729 records identified, 14 studies met the inclusion criteria. Understanding the diverse spectrum of allergic manifestations of this condition is vital. This review consolidates findings on AGS-related complications, including immediate and delayed anaphylaxis, hypersensitivity reactions to mammalian-derived medical products, and blood transfusions. However, the available evidence is primarily derived from observational studies conducted in the United States, which may limit the generalizability of current findings. By highlighting the broader implications of AGS, this review underscores awareness in acute and perioperative settings.
Patel R, Patel A, Biswas R, Hsieh B, Ramasamy D, et al.
Case reports in immunology •
Alpha-gal syndrome (AGS) is an uncommon IgE-mediated allergy to mammalian-derived products, caused by sensitization to the oligosaccharide galactose-α-1,3-galactose (alpha-gal) after tick exposure. Although AGS is best recognized for delayed anaphylaxis following ingestion of red meat, its implications for exposure to mammalian-derived biomaterials remain poorly characterized. We present an elderly woman with AGS who required transcatheter aortic valve replacement (TAVR) using a bovine bioprosthesis. An 84-year-old woman with serologically confirmed AGS following a Lone Star tick bite in 2012 presented with symptomatic severe aortic stenosis. Her clinical history included multiple allergic reactions to beef, persistently elevated IgE to beef, pork, and lamb, and a specific alpha-gal IgE >100 kU/L. Following a multidisciplinary evaluation, she was not considered a candidate for a mechanical valve. A prophylactic regimen was implemented, including cetirizine, omalizumab, and 60 mg prednisone 6 h prior to TAVR. The procedure was successfully performed with a bovine-derived bioprosthetic valve. Perioperative tryptase levels remained within normal range (5.2 µg/L), and no hypersensitivity reactions occurred. Postoperatively, prednisone was tapered, while fexofenadine and omalizumab were continued for 6 months. This case highlights that bioprosthetic valve replacement can be safely performed in AGS patients through multidisciplinary planning and individualized prophylaxis strategies. Further data are needed to develop standardized perioperative management protocols for this rare but clinically significant condition.
Patel R, Jaglan A, Aguileraserna C, Pandya K, Goldstein L
Cureus •
Allergies are a very common pathology and their manifestations consist of a spectrum of presentations, ranging from minimal discomfort like a runny nose to lethal reactions like anaphylaxis and death. Meat allergy is not a very common form of allergy, even though there is a relatively high level of meat consumption. One of the rare forms of non-primate mammalian meat allergy is alpha-gal syndrome (AGS). It is related to IgE antibodies specific for galactose-α-1,3-galactose (α-Gal). It is triggered in sensitized individuals due to multiple bites of lone star tick bites (). Here we present a 63-year-old male with a complaint of recurrent hives and tongue swelling, developed recently after traveling to Twinsburg, OH. There is no significant history of any allergic conditions. Vital signs were stable with a normal physical examination. The patient had normal routine labs including eosinophil count, thyroid-stimulating hormone (TSH), iron panel, and negative HIV. Allergy testing showed normal total IgE but increased levels of IgE for allergens like beef, lamb, and pork (18.4, 6.71, and 7.62 respectively) and greatly increased levels of IgE for alpha-gal (42.7). Sensitization to alpha-gal can cause delayed allergic symptoms upon consuming various non-primate mammalian types of meat, particularly beef, pork, and lamb. Conditions like AGS are rare and can be missed as an initial diagnosis in many patients. A high degree of vigilance is required to diagnose such conditions.